Dementia is the signature disease of an aging society. It affects both patients and the families who look after them. With a growing aging population we will see an increasing number of cases of dementia. Some have called it the silver tsunami. Alzheimer’s disease (AD), which constitutes 60-80% of all dementia cases, passed diabetes in 2006 to become the sixth leading cause of death in the United States. For San Diego County it is the fourth cause of death. An estimated 72,914 Americans died of Alzheimer’s disease in 2006. A recent Alzheimer's Association report estimates that 5.2 million people in the United States have the disease, which is expected to afflict 20 million Americans by 2050.
Dementia means a gradual and progressive decline in memory, thinking and reasoning skills. Living with a degenerating disease that erodes an individual’s ability to think and behave rationally has many social implications, one of which is making decisions. Having problems with thinking also leads to an increased rate of physical decline. However, although we are learning more and more about the disease, we have not managed to find, or come close to finding, a cure.
It has often been assumed that cognitive decline, especially related to AD, is related to deterioration in the brain’s mechanism. This theory, however, does not fully explain new evidence. For example, autopsy studies have shown that approximately a third of individuals with the disease exhibit no sign of dementia at the time of their death. AD is unlike Parkinson’s disease. With Parkinson’s, 80% or more of cells in specific part of the brain must be lost in order for the initial symptoms to appear. With AD there seems to be a reserve or capacity for deterioration before symptoms of the disease appear. Building one’s brain capacity is therefore important.
Although a healthy brain reflects a healthy lifestyle, it is not necessarily true that a diseased brain reflects an unhealthy lifestyle. Although one’s ongoing problems with health can lead to dementia, no one is immune from the disease. For example, diabetes, heart disease, high cholesterol, and high blood pressure all contribute to the development of vascular dementia. Therefore physical exercise is essential for reducing and delaying the emergence of these risk factors. Statistics show that if the onset of Alzheimer’s could be delayed by five years, the number of people with the disease would be cut in half. Even delaying the onset of Alzheimer’s symptoms by as little as one year would reduce the occurrence of the disease by 12 million cases according to a 2050 projection. Despite all these precautions, the disease cannot be avoided. As a society we need to accept this disease and work with caregivers to provide support and alleviate the guilt that so often accompanies AD.
SDSU gerontology program is looking at ways to support family members who are caring for their loved ones by helping them also care for themselves. If you suspect you have dementia, or a loved one has dementia, first talk to someone. Apart from friends, relatives, and neighbors there are a number of agencies that offer free support in San Diego County.
Do not blame the victim. They are frightened, too. Do not blame yourself. Preparing for the disease of the 21st Century involves working with the whole family, not just the patient.
Mario Garrett PhD is a professor of gerontology at San Diego State University. He can be reached at mariusgarrett@yahoo.com © Mario Garrett 2010
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